Intensive Rehabilitation for Multiple Sclerosis

Multiple Sclerosis is incurable and can be debilitating but with the right care, some sufferers can manage to lead relatively independent lives. After suffering the symptoms of multiple sclerosis for more than 20 years, 49-year-old Emirati Darwish set a goal for himself that most take for granted: standing up on his own two feet with no support. Between the struggles and suc­cesses on the journey to achiev­ing his aim, Darwish reached his milestone in under one month thanks to a customized post-acute rehabilitation programme developed especially for patients with MS.

“I’ve fallen twice and both times, I couldn’t lift myself be­cause I was always dependent on my right leg as it was stron­ger than my left leg,” Darwish adds, relaying that the solution was having the occupational therapist hoist him in standing position and strengthening his muscles through physiothera­py until he was able to support himself on both legs. “I was suc­cessful,” he recounts. In developing Darwish’s post-acute rehabilitation programme, specialist physicians used a multidisciplinary approach in­volving three to five hours dai­ly of customized physiotherapy alongside occupational therapy, speech therapy and a special nu­trition plan. The combined programme was developed with the aim of helping Darwish recover func­tion in independence, from get­ting out of bed to exercising and developing his core. Darwish has one occupational therapist, Beth, who works with him all the time. He believes that it’s important to work with the same person consistently because he receives seamless care and she develops an under­standing for his medical needs and, importantly, provides emo­tional support as well.

“I don’t call it a hospital, I call it a home,” says Darwish on the significance of being in a happy and emotionally supportive en­vironment. Beyond the care of staff, Darwish’s family can visit him any time they please, with the room adaptable for them to stay with him. Recalling his first experience with the condition, Darwish dis­covered something was wrong in 1988. “It started with numbness in one of my legs and then it moved to both of them:’ he says.”It was weird. It would happen once a year and then disappear.” Initially, doctors were unable to diagnose Darwish’s problem. Although he had issues, he was able to continue leading an ac­tive lifestyle.

Eventually, in 1994, the Emi­rati’s condition worsened, so he travelled to Germany for tests. Since at the time there was no MRI scanner available in the UAE. “There was a professor there who took some fluid from my back. After the MRI and the blood test, it was confirmed that I have multiple sclerosis!” MS is a chronic condition where the central nervous sys­tem is attacked by the body’s own immune cells, affecting the spine and the brain. It can cause difficulty with mobility, balance and result in fatigue. It can also affect the bladder and cause issues with sufferers’ cog­nitive abilities. Of the two broad forms of the condition, Darwish has the secondary progressive form of MS, meaning he has severe episodes separated by long periods of remission from symptoms. Primary progressive MS is a rarer form of the condi­tion where sufferers’ symptoms steadily worsen with no periods of remission. There are times when symptoms stabilize, but they never disappear.

After a recent serious relapse, Darwish was unable to walk properly and his legs were be­coming weak, which led him to Amana Healthcare’s rehabilita­tion hospital in Abu Dhabi. Having improved significant­ly during his inpatient stay, Darwish’s next step is a period of transitional care in which ther­apy staff from Amana will sup­port him in the transition from hospital to home and provide him with a specialised home-based rehabilitation programme or nursing support as needed. A team of physical and occupa­tional therapists have visited his home, looking at various ways they can improve his environ­ment and enable him to overcome potential difficulties. “I’m going to put a moveable ramp at the back of my house,” he says, in preparation for situations where he needs to use his wheelchair. Darwish is due to be discharged after just over one month of intensive treatment. Witnessing the accomplishments that Darwish has made over a short span of time, he has inspired himself, his family and staff that truer words could not apply when it comes to any hardship in life — if at first you don’t succeed, try again.